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Functional Lead Cincinnati - OH - Ohio

Sierra Business Solution LLC

Cincinnati, Ohio • 3d ago

Contract, Third Party

$45 - $45

Job Details

Skills

Facets
Testing

Summary

Must Have TechnicalFunctional Skills

Strong SME knowledge in Healthcare Claims Processing lifecycle

Expertise in EDI formats 837 (PID), 835, 834

Hands-on experience in Facets (Claims + Enrollment modules)

Proficiency in Azure DevOps (ADO) for QA tracking

Knowledge of HIPAA compliance and payer systems

8+ years of experience in Healthcare QATesting

4+ years of experience as Test Lead in Facets projects

Deep understanding of Claims Adjudication & Payment workflows

Experience in handling claims denials, adjustments, and reprocessing

Strong exposure to EDI claim and remittance transactions

Experience in mocking and validating EDI files (837835834)

Knowledge of ITS claims processing (SF, DF, RF)

Experience in Member Enrollment workflows (Medicaid, Medicare, ACA)

Understanding of Billing lifecycle for member enrollment

Hands-on experience with ADO Test Plans, Test Suites, and Defect tracking

Ability to perform data validation and reconciliation activities

Strong experience in functional and end-to-end testing

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 90911958
Position Id: 9045011
Posted 3 days ago

Fitment

Dice Job Match Score™

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Role: Manual tester Work location remote Need Mandatory Facets Experience Healthcare EDI 837 Manual Tester with Facets Experience We are looking for an experienced Healthcare EDI Manual Tester / QA Analyst with strong hands-on experience in 837 Professional (837P) and Institutional (837I) claims and TriZetto Facets. Required Skills * 5+ years of experience in Healthcare IT / Claims / EDI testing. * Strong hands-on experience with manual testing of 837P and 837I healthcare claims. * Strong u

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Contract

$40 - $50

MMIS Claims Tester

Remote

•

8d ago

MMIS Claims Tester Client Minds Print Location: Remote but 25% travel would be required during critical phases Responsibilities Must have very good understanding of the healthcare payer space with a minimum experience of 10 years in the domain. Must have a prior experience in implementing/maintenance of commercial payer claims solution and/or Medicare/Medicaid system Must have good experience with claims processing concepts, along with the provider, member enrolment and care management con

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Third Party, Contract

$40 - $45

Heathcare Enrollment Specialist

Remote

•

7d ago

Healthcare Enrollment Specialist LONG TERM CONTRACT FULLY REMOTE STARTS ASAP Job Title:Healthcare Enrollment Specialist Location:Remote Job Summary We are seeking a detail-oriented and dependableEnrollment Specialistto join our team. You will be responsible for accurately processing health plan enrollment, changes, and terminations for our members. You will work within our healthcare administration software, ensure compliance with regulatory standards (CMS, ACA, state guidelines), and support sm

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Contract

Depends on Experience

Senior Quality Assurance/Application Testing Specialist (UAT)

Remote

•

24d ago

Position Summary We are seeking an experienced Senior QA Automation & User Acceptance Testing (UAT) Specialist to support enterprise-level Medicaid modernization initiatives. The successful candidate will be responsible for planning, executing, and validating quality assurance activities across complex healthcare applications, ensuring system functionality aligns with approved business requirements. This role requires strong expertise in test automation, User Acceptance Testing (UAT), enterprise

Easy Apply

Contract

45 - 50

Search all similar jobs

More jobs at Sierra Business Solution LLC in Cincinnati, OH

Job Details

Skills

Facets
Testing

Summary

Must Have TechnicalFunctional Skills

Strong SME knowledge in Healthcare Claims Processing lifecycle

Expertise in EDI formats 837 (PID), 835, 834

Hands-on experience in Facets (Claims + Enrollment modules)

Proficiency in Azure DevOps (ADO) for QA tracking

Knowledge of HIPAA compliance and payer systems

8+ years of experience in Healthcare QATesting

4+ years of experience as Test Lead in Facets projects

Deep understanding of Claims Adjudication & Payment workflows

Experience in handling claims denials, adjustments, and reprocessing

Strong exposure to EDI claim and remittance transactions

Experience in mocking and validating EDI files (837835834)

Knowledge of ITS claims processing (SF, DF, RF)

Experience in Member Enrollment workflows (Medicaid, Medicare, ACA)

Understanding of Billing lifecycle for member enrollment

Hands-on experience with ADO Test Plans, Test Suites, and Defect tracking

Ability to perform data validation and reconciliation activities

Strong experience in functional and end-to-end testing

Dice Id: 90911958
Position Id: 9045011
Posted 3 days ago

Fitment

Dice Job Match Score™

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Remote

•

Today

Easy Apply

Contract

$40 - $50

MMIS Claims Tester

Remote

•

8d ago

Easy Apply

Third Party, Contract

$40 - $45

Heathcare Enrollment Specialist

Remote

•

7d ago

Easy Apply

Contract

Depends on Experience

Senior Quality Assurance/Application Testing Specialist (UAT)

Remote

•

24d ago

Easy Apply

Contract

45 - 50

Search all similar jobs

More jobs at Sierra Business Solution LLC in Cincinnati, OH

Functional Lead Cincinnati - OH - Ohio

Skills

Summary

Dice Job Match Score™

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Functional Lead Cincinnati - OH - Ohio

Job Details

Skills

Summary

Dice Job Match Score™

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